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Do You Know What Your Doctor Said?: Medical Records & Treatment

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A recent article in the Wall Street Journal entitled, “Access to Doctor’s Notes Aids Patients’ Treatment“, highlights an interesting topic of patients actually reading, or requesting,  their medical records from visits with their primary care physician.

The study was entitled “OpenNotes” and published in the Annals of Internal Medicine. Ultimately the study concluded that an overwhelming 77% to 87% of patients felt more in control of their medical care and were more compliant with their prescription medication.  Initially, there were concerns from  physicians that their notes may offend or scare off patients but 105 primary care physicians participated in the study. Interestingly, the article points out that only about 34% of doctors nationwide have adopted electronic medical records.

From the perspective of this plaintiff’s attorney, when you think about the other audiences reviewing your records:

  1. referring physicians to further your care; (Good)
  2. insurance companies and adjusters to deny your medical benefits to save them money; (Bad) and
  3. both plaintiff and defense attorneys for disputes in personal injuries, workers’ compensation claims, and/or social security disability claims. (Good & Bad)

The only logical step is to ensure you as a patient are just as knowledgeable of your own records as the jack legged insurance adjuster combing through your file to find anything to deny you benefits you deserve, while falsely acting as if they have medical degrees.

In the end you know, it is your body and your life. Yes, you are legally entitled to those records, too.

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Doctors, Patients, and Pain Medication: The Perfect Cure for All that Ails

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Insurance companies and defense attorneys frequently question injury claimants on their specific degree of pain and suffering. Knowing this is a subjective element of damages the big corporations and their hired guns move next to the medical providers to seek better clarity. Inevitably there is the case where the doctor did not believe the patient was truly in pain but subsequently prescribed pain medicine. Why on Earth would a medical provider be at such odds with themselves? It must be because he fears legal repercussions and higher insurance premiums, right? Or is it because he is paid more, or even paid by the pharmaceutical company?

Two articles caught my attention over the past few days:

  1. “Diagnosing a Patient as a Faker” by Melinda Beckof the WSJ– reporting on several issues in medicine and not totally in line with her eye catching headline. However, she cites the Archives of Internal Medicine, 2011 indicating: a) Prescriptions rose nearly 50% from 2000-2009, b) Abuse of opioid pain relievers is the second leading cause of accidental death in the U.S., after car crashes, and c) 15%-20% of doctor visits in the U.S. involve an opioid prescription; and
  2. “Doctors Already Know Secret to Better Health Care” by Walter Ezellin The Greenville News-illustrating the need for more in depth time between patients and doctors, not just quick visits, drugs, and positive reinforcement for negative health habits. To quote Ezell’s article:

Only medical doctors can prescribe prescription medicine or perform surgery. This isn’t necessarily because surgery and drugs are the most important contributors to human health, but because in the wrong hands, they are dangerous.

Here is the paradox. Because doctors have a monopoly on drugging and invasive procedures, and spent a lot of money to join the guild, they get paid more for those practices and need to get paid well. There is an economic incentive to do more drugging and surgery, with little incentive to give patients the time, empathy and wisdom that are critical to achieving optimum health.

Doctors who want to address the whole person (and there are many) are swimming against the tide of their own economic interest. Unless they are working in an academic medical center, or already involved in an alternative practice, they may not have time to lavish the needed attention that each patient deserves.

We could all use more in depth time with our doctors in explaining all that ails us. The doctors may prefer more one on one time but being mandated by corporate interests within the hospital administration and/or through pure bottom line views of paying overhead, can’t manage this need.

Patients are certainly to blame in going into the doctor’s office and not being as detailed as possible in explaining mechanisms of injury or symptoms. Of course, some patients probably take advantage of this being their only human interaction outside their normal day and talk about unrelated issues.

The bottom line is that only doctors can prescribe pain medications and only patients can control their adherence to healthy habits. Unfortunately there is too much subjective gray area in between and too many entities vying for a piece of that control.

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Big Companies Make Big Mistakes and then Act Like Babies

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Fortune Magazine had an Opinion article by journalist, Becky Quick, entitled:

“Toyota. Boston Scientific. Big Banks. Why So Many Companies Can’t Say ‘We’re Sorry,’ And Why That’s Bad for Business.”

Ms. Quick retells the account of an 84-year-old patient that had a Boston Scientific defibrillator and received an accidental shock to his heart.  Instead of apologizing the company sent letters to the medical journal that printed the account questioning the doctor that observed the incident.

We all know the plight of our tax money going to the Big Banks that were “Too Big to Fail”.

Toyota’s rise to global infamy may have come as a surprise to many consumers but not to Toyota as the Wall Street Journal reported knowledge of the problem with the gas pedals for nearly a year before the company was actually forced to admit to it.  (Secretive Culture Led Toyota Astray by WSJ).

Interestingly, Ms. Quick poses this question and then answers it herself:

So why do corporate execs seem to have such a hard time making apologies? Maybe because admitting a mistake can be expensive when you head a major corporation. Plaintiffs’ lawyers would have a field day with an apology, and recalling a product is expensive. Levick, a crisis-communications firm that has helped companies recall more than 100 products, estimates that it costs twice as much to recall a product as it does to litigate claims related to faulty goods.

I have gone over Costs Benefits Analysis in other blog posts. As a consumer you need to become a little more conscientious about what you are buying and from whom. Otherwise, your ignorance will work hand and hand with the profit analysis of big corporations. Those corporations count on your fear in making that call to get help from Plaintiffs’ lawyers when the company’s products do harm to you or your loved ones.

None of you will care until it happens to you, your son, your daughter, husband, wife, or loved one. I remember my early days with the American Red Cross. I worked with the blood services side because I had been a cancer survivor that received blood and platelets. Who better to recruit donors?  My spill to potential donors was always this:

If you or your loved one had a horrible wreck, got stricken with cancer, or needed blood or platelets immediately, wouldn’t you go to the hospital and expect it to be there? Why? You aren’t willing to give it yourself. Why should you or your loved one get it?

People usually got the point but the Red Cross thought my approach was a little too intense.  I went to law school where my intensity could be better focused on companies that do wrong. Never a shortage in work there.